Fernando Alarid-Escudero, PhD

Fernando Alarid-Escudero, PhD

Health Decision Scientist

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Registro de señales de EEG para aplicaciones de Interfaz Cerebro Computadora (ICC) basado en Potenciales Evocados Visuales de Estado Estacionario (PEVEE)

Published:

This paper presents an implementation of an effective synchronization between a registration and a stimulation module that are part of a steady state visual evoked potential (SSVEP)-based Brain Computer Interface (BCI).

Recommended citation: Alarid-Escudero F, Solís-Escalante T., Melgar E., Valdés-Cristerna R., Yánez-Suárez O. Registro de seńales de EEG para aplicaciones de interfaz cerebro computadora (ICC) basado en Potenciales Evocados Visuales de Estado Estacionario (PEVEE). CLAIB 2007 IFMBE Proceedings, 2007;18:87–90. https://doi.org/10.1007/978-3-540-74471-9_21

dissemination

funding

Comparative Modeling to Inform Cervical Cancer Control Policies

Published:

This projects will pursue analyses related to the impact of newly-revised screening and HPV vaccination guidelines, the comparative effectiveness of forthcoming screening and HPV vaccination strategies and approaches, optimal screening and vaccination strategies in women living with HIV, the optimal routes for reducing cervical cancer disparities, and the potential for cervical cancer elimination in the US, and optimal screening and vaccination strategies for women living with HIV.

portfolio

publications

Registro de señales de EEG para aplicaciones de Interfaz Cerebro Computadora (ICC) basado en Potenciales Evocados Visuales de Estado Estacionario (PEVEE)

Published in CLAIB 2007 IFMBE Proceedings, 2007

This paper presents an implementation of an effective synchronization between a registration and a stimulation module that are part of a steady state visual evoked potential (SSVEP)-based Brain Computer Interface (BCI).

Recommended citation: Alarid-Escudero F, Solís-Escalante T., Melgar E., Valdés-Cristerna R., Yánez-Suárez O. Registro de seńales de EEG para aplicaciones de interfaz cerebro computadora (ICC) basado en Potenciales Evocados Visuales de Estado Estacionario (PEVEE). CLAIB 2007 IFMBE Proceedings, 2007;18:87–90. https://doi.org/10.1007/978-3-540-74471-9_21

Cost-benefit analysis: HIV/AIDS prevention in migrants in Central America

Published in Salud Pública de México, 2012

This paper is about the use of cost-benefit analysis to quantify the costs and benefits of three HIV prevention interventions in migrants in Central America: voluntary counseling and testing, treatment of sexually transmitted infections, and condom distribution. The results suggest that the HIV prevention programs in Central America can potentially result in monetary savings in the long run.

Recommended citation: Alarid-Escudero F, Sosa-Rubí SG, Fernández B, Galárraga O. Cost-benefit analysis: HIV/AIDS prevention in migrants in Central America. Salud Pública de México. 2013;55(S1):S23-30. https://scielosp.org/article/spm/2013.v55suppl1/S23-S30/

Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery

Published in Birth, 2016

In this paper, a probabilistic decision-analytic model was used to estimate the cost-effectiveness of Medicaid coverage of doula services. Cost-effectiveness analyses indicate potential savings associated with doula support reimbursed at an average of $986.

Recommended citation: Kozhimannil KB, Hardeman RR, Alarid-Escudero F, Vogelsang C, Blauer-Peterson C, Howell EA. Modeling the cost-effectiveness of doula care for reducing preterm birth and cesarean delivery. Birth. 2016;43(1):20-27. https://doi.org/10.1111/birt.12218

An Overview of R in Health Decision Sciences

Published in Medical Decision Making, 2017

This article provides an overview of existing R functionality that is applicable to the various stages of decision analysis, including model design, input parameter estimation, an analysis of model outputs.

Recommended citation: Jalal H, Pechlivanoglou P, Krijkamp E, Alarid-Escudero F, Enns EA, Hunink, MGM. An Overview of R in Health Decision Sciences. Medical Decision Making, 2017;37(7):735-746. https://doi.org/10.1177/0272989X16686559

Prioritizing Future Research on Allopurinol and Febuxostat for the Management of Gout: Value of Information Analysis

Published in PharmacoEconomics, 2017

The aim of this study was to quantify the value of conducting additional research and reducing uncertainty regarding the cost effectiveness of allopurinol and febuxostat for the management of gout. We used a Markov model that evaluated the cost effectiveness of nine urate-lowering strategies over the lifetime of a hypothetical gout patient.

Recommended citation: Jutkowitz E, Alarid-Escudero F, Choi HK, Kuntz KM, Jalal H. Prioritizing Future Research on Allopurinol and Febuxostat for the Management of Gout: Value of Information Analysis. PharmacoEconomics, 2017;35(10):1073-1085. https://doi.org/10.1007/s40273-017-0526-0

Trade-offs Between Efficacy and Cardiac Toxicity of Adjuvant Chemotherapy in Early-Stage Breast Cancer Patients: Do Competing Risks Matter?

Published in The Breast Journal, 2017

In this paper, a decision-analytic framework is used to quantify the trade-offs between effectiveness and long-term cardiac toxicity of adjuvant chemotherapy by combining the available evidence into a single, comparable metric. It is developed a Markov model to simulate a hypothetical cohort of newly diagnosed breast cancer patients under three scenarios: no treatment, anthracycline (AC)-based adjuvant chemotherapy (more effective but also more cardiotoxic), and non-AC-based adjuvant chemotherapy.

Recommended citation: Alarid-Escudero F, Blaes A, Kuntz KM. Trade-offs between efficacy and cardiac toxicity of adjuvant chemotherapy in early-stage breast cancer patients: Do competing risks matter? The Breast Journal, 2017;23(4):401-9. https://doi.org/10.1111/tbj.12757

A Kinked Health Insurance Market: Employer-Sponsored Insurance under the Cadillac Tax

Published in American Journal of Health Economics, 2017

In this paper using economic theory and a microsimulation model, we predict how employers will respond to the Cadillac tax by adjusting wages and health insurance benefits. The results suggest that the Cadillac Tax will impose a hard cap on health insurance benefits, causing a clustering of benefits at the thresholds and a sharp reduction in the variance of benefits.

Recommended citation: Drake C, Higuera L, Alarid-Escudero F, Feldman R. A kinked health insurance market: Employersponsored insurance under the Cadillac tax. American Journal of Health Economics, 2017;3(4):455-76. Available at SSRN: https://ssrn.com/abstract=2925303 https://ssrn.com/abstract=2925303

Published in , 1900

Microsimulation Modeling for Health Decision Sciences Using R: A Tutorial

Published in Medical Decision Making, 2018

In this tutorial, we provide a step-by-step guide to build microsimulation models in R and illustrate the use of this guide on a simple, but transferable, hypothetical decision problem.

Recommended citation: Krijkamp EM, Alarid-Escudero F, Enns EA, Jalal H, Hunink MGM, Pechlivanoglou P. Microsimulation modeling for health decision sciences using R: A tutorial. Medical Decision Making, 2018;38(3):400-422. https://doi.org/10.1177/0272989X18754513

Force of infection of Helicobacter pylori in Mexico: evidence from a national survey using a hierarchical Bayesian model

Published in Epidemiology and Infection, 2018

In this article, we estimated the age-specific rate at which susceptibles acquire infection (force of infection) of Helicobacter pylori in Mexico.

Recommended citation: Alarid-Escudero F, Enns EA, MacLehose R, Parsonnet J, Torres J, Kuntz KM. Force of infection of H. pylori in Mexico: Evidence from a national survey using a hierarchical Bayesian model. Epidemiology and Infection, 2018;146(8):961-9. https://doi.org/10.1017/S0950268818000857

Revisiting assumptions about age-based mixing representations in mathematical models of sexually transmitted infections

Published in Vaccine, 2018

In this paper, we compare the fit of different mixing representations to survey data and the impact of different mixing assumptions on the predicted benefits of hypothetical human papillomavirus (HPV) vaccine strategies.

Recommended citation: Easterly CA, Alarid-Escudero F, Enns EA, Kulasingam S. Revisiting Assumptions about AgeBased Mixing Representations in Mathematical Models of Sexually Transmitted Infections. Vaccine, 2018;36(37):5572-5579. https://doi.org/10.1016/j.vaccine.2018.07.058

Nonidentifiability in Model Calibration and Implications for Medical Decision Making

Published in Medical Decision Making, 2018

In this paper, a 3-state Markov model of cancer relative survival (RS) is used to evaluate the implications of nonidentifiability on the optimal strategy.

Recommended citation: Alarid-Escudero F, MacLehose RF, Peralta Y, Kuntz KM, Enns EA. Non-identifiability in model calibration and implications to medical decision making. Medical Decision Making, 2018;38(7):810-21. https://doi.org/10.1177/0272989X18792283 https://doi.org/10.1177/0272989X18792283

Incorporating Biomarkers into the Primary Prostate Biopsy Setting: A Cost-Effectiveness Analysis

Published in The Journal of Urology, 2018

In this paper, we performed a cost-effectiveness analysis using the PHI (Prostate Health Index), 4Kscore ®, SelectMDx ™ and the EPI (ExoDx ™ Prostate [IntelliScore]) in men with elevated prostate specific antigen to determine the need for biopsy.

Recommended citation: Sathianathen NJ, Kuntz KM, Alarid-Escudero F, Lawrentschuk NL, Bolton DM, Murphy DG, Weight CJ, Konety BR. Incorporating biomarkers into the primary prostate biopsy setting: a costeffectiveness analysis. The Journal of Urology, 2018;200(6):1215-1220. https://doi.org/10.1016/j.juro.2018.06.016

The Curve of Optimal Sample Size (COSS): A Graphical Representation of the Optimal Sample Size from a Value of Information Analysis

Published in PharmacoEconomics, 2019

This paper introduces the curve of optimal sample size (COSS), which is a graphical representation of summary data for decision makers to determine the sample size that optimizes research funding given their operating characteristics from a VOI analysis.

Recommended citation: Jutkowitz E, Alarid-Escudero F, Kuntz KM, Jalal H. The Curve of Optimal Sample Size (COSS): a Graphical Representation of the Optimal Sample Size from a Value of Information Analysis. PharmacoEconomics, 2019;37(7):871-877. https://doi.org/10.1007/s40273-019-00770-z. https://doi.org/10.1007/s40273-019-00770-z

“Time Traveling Is Just Too Dangerous” but Some Methods Are Worth Revisiting: The Advantages of Expected Loss Curves Over Cost-Effectiveness Acceptability Curves and Frontier

Published in Value in Health, 2019

This paper is about the use of a probabilistic sensitivity analysis of a CEA that compares 6 cerebrospinal fluid biomarker test-and-treat strategies in patients with mild cognitive impairment. The results illustrate the limitations of currently recommended methods for communicating uncertainty and the demonstrated that ELCs provide a more comprehensive representation of uncertainty.

Recommended citation: Alarid-Escudero F, Enns EA, Kuntz KM, Michaud TL, Jalal H. “Time Traveling Is Just Too Dangerous" But Some Methods Are Worth Revisiting: The Advantages of Expected Loss Curves Over Cost-Effectiveness Acceptability Curves and Frontier. Value in Health, 2019;22(5):611-618. https://doi.org/10.1016/j.jval.2019.02.008. https://doi.org/10.1016/j.jval.2019.02.008

Estimated Quality of Life and Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies A Cost-effectiveness Analysis

Published in JAMA Internal Medicine, 2019

In this paper, we estimate the cost-effectiveness of 12 cervical cancer screening strategies.

Recommended citation: Sawaya G, Sanstead E, Alarid-Escudero F, Smith-McCune K, Gregorich SE, Silverberg M, Leyden W, Huchko MJ, Kuppermann M, Kulasingam S Estimated Quality of Life and Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies: A Cost-effectiveness Analysis. JAMA Internal Medicine, 2019;179(7):867-878. https://doi.org/10.1001/jamainternmed.2019.0299. https://doi.org/10.1001/jamainternmed.2019.0299

Cost-effectiveness Analysis of Active Surveillance Strategies for Men with Low-risk Prostate Cancer

Published in European Urology, 2019

In this paper, we developed a state-transition Markov model to assess the costs and benefits of different Active surveillance (AS) follow-up strategies compared to watchful waiting (WW) or immediate treatment.

Recommended citation: Sathianathen NJ, Konety BR, Alarid-Escudero F, Lawrentschuk NL, Bolton DM, Murphy DG, Weight CJ, Kuntz KM. Cost-effectiveness Analysis of Active Surveillance Strategies for Men with Low-risk Prostate Cancer. European Urology, 2019;75(6):910-917. https://doi.org/10.1016/j.eururo.2018.10.055. https://doi.org/10.1016/j.eururo.2018.10.055

Characterization and valuation of uncertainty of calibrated parameters in stochastic decision models

Published in arXiv, 2019

In this paper, we evaluated the implications of different approaches to characterize uncertainty of calibrated parameters of stochastic decision models (DMs) in the quantified value of such uncertainty in decision making. We used a microsimulation DM of colorectal cancer (CRC) screening to conduct a cost-effectiveness analysis (CEA) of a 10-year colonoscopy screening.

Recommended citation: Alarid-Escudero F, Knudsen AB, Ozik J, Collier N, Kuntz KM. Characterization and valuation of uncertainty of calibrated parameters in stochastic decision models. arXiv:1906.04668. 2019. https://arxiv.org/abs/1906.04668

A Value of Information Analysis of Research on the 21-Gene Assay for Breast Cancer Management

Published in Value in Health, 2019

In this paper, we aim to quantify the value of conducting further research to reduce decision uncertainty in the use of the 21-gene assay Oncotype DX (21-GA).

Recommended citation: Kunst N, Alarid-Escudero F, Paltiel D, Wang SY. A value of information analysis of research on the 21-gene assay for breast cancer management. Value in Health, 2019;22(10):1102-1110. https://doi.org/10.1016/j.jval.2019.05.004. https://doi.org/10.1016/j.jval.2019.05.004

A Need for Change! A Coding Framework for Improving Transparency in Decision Modeling

Published in PharmacoEconomics, 2019

In this paper, we introduced the Decision Analysis in R for Technologies in Health (DARTH) framework that consists of a conceptual, modular structure and coding recommendations for the implementation of model-based decision analyses in R. This framework defines a set of common decision model elements divided into five components: (1) model inputs, (2) decision model implementation, (3) model calibration, (4) model validation, and (5) analysis.

Recommended citation: Alarid-Escudero F, Kuntz KM. (2019). "A Need for Change! A Coding Framework for Improving Transparency in Decision Modeling." PharmacoEconomics. 37(11):1329–1339. https://link.springer.com/article/10.1007/s40273-019-00837-x

A Cost-effectiveness Analysis of Systemic Therapy for Metastatic Hormone-sensitive Prostate Cancer

Published in European Urology Oncology, 2019

In this paper, we performed a cost-effectiveness analysis of immediate docetaxel or abiraterone acetate treatment in addition to ADT in men with metastatic hormone-sensitive prostate cancer (PC).

Recommended citation: Sathianathen NJ, Alarid-Escudero F, Kuntz KM, Lawrentschuk NL, Bolton DM, Murphy DG, Kim SP, Konety BR. A Cost-effectiveness Analysis of Systemic Therapy for Metastatic Hormonesensitive Prostate Cancer. European Urology Oncology, 2019;2(6):649-755. https://doi.org/10.1016/j.euo.2019.01.004. https://doi.org/10.1016/j.euo.2019.01.004

Midwife‐led care and obstetrician‐led care for low‐risk pregnancies: A cost comparison

Published in Birth, 2019

In this paper, we used a decision‐analytic approach to show that a shift from obstetrician‐led care to midwife‐led care for low‐risk pregnancies could be cost saving and potentially support broad efforts to improve quality and value in the US maternity care.

Recommended citation: Attanasio LB, Alarid-Escudero F, Kozhimannil KB. (2020). "Midwife‐led care and obstetrician‐led care for low‐risk pregnancies: A cost comparison." Birth. 47(1):57-66. https://onlinelibrary.wiley.com/doi/full/10.1111/birt.12464

Potential bias associated with modeling the effectiveness of healthcare interventions in reducing mortality using an overall hazard ratio

Published in PharmacoEconomics, 2019

In this paper, we quantified the bias associated with using oHR as an intervention’s effectiveness beyond the time horizon of the clinical trial and derived an expression of dsHR as a function of the estimated oHR and the characteristics of the trial’s study population.

Recommended citation: Alarid-Escudero F, Kuntz KM. (2020). "Potential bias associated with modeling the effectiveness of healthcare interventions in reducing mortality using an overall hazard ratio." PharmacoEconomics. 38(3):285-296. https://rdcu.be/b1Ize

A Multidimensional Array Representation of State-transition Model Dynamics

Published in Medical Decision Making, 2020

This paper is about the use of multidimensional arrays to represent and store transition dynamics of simulated cohorts with state-transition models.

Recommended citation: Krijkamp E, Alarid-Escudero F, Enns EA, Pechlivanoglou P, Hunink MGM, Yang A, Jalal H. (2020). "A Multidimensional Array Representation of State-transition Model Dynamics." Medical Decision Making. 40(2):242-248. https://doi.org/10.1177/0272989X19893973

Calculating the Expected Value of Sample Information in Practice: Considerations from 3 Case Studies

Published in Medical Decision Making, 2020

In this paper, we compared 4 expected value of sample information (EVSI) methods using 3 previously published health economic models. The aim of the study was to compare these methods performance across realistic examples.

Recommended citation: Heath A, Kunst NR, Jackson C, Strong M, Alarid-Escudero F, Goldhaber-Fiebert JD, Baio G, Menzies N, Jalal H. Calculating the Expected Value of Sample Information in Practice: Considerations from Three Case Studies. Medical Decision Making, 2020;40(3):314-326. https://doi.org/10.1177/0272989X20912402. https://doi.org/10.1177/0272989X20912402

Computing the Expected Value of Sample Information Efficiently: Practical Guidance and Recommendations for Four Model-Based Methods

Published in Value in Health, 2020

This report provides practical guidance and recommendations to help inform the choice between 4 expected value of sample information (EVSI) estimation methods.

Recommended citation: Kunst NR, Wilson E, Glynn D, Alarid-Escudero F, Baio G, Brennan A, Fairley M, GoldhaberFiebert JD, Jackson C, Jalal H, Menzies N, Strong M, Thom H, Heath A, on behalf of theCollaborative Network for Value of Information (ConVOI). Computing the Expected Value of Sample Information Efficiently: Practical Guidance and Recommendations for Four Model-Based Methods. Value in Health, 2020;23(6):734-742. https://doi.org/10.1016/j.jval.2020.02.010. https://doi.org/10.1016/j.jval.2020.02.010

Published in , 1900

Cost-effectiveness analysis of a multidisciplinary health-care model for patients with type-2 diabetes implemented in the public sector in Mexico: A quasi-experimental, retrospective evaluation

Published in Diabetes Research and Clinical Practice, 2020

In this paper, we compared the cost-effectiveness of the multidisciplinary health-care model (MHC) vs. the conventional health-care model (CHC) implemented by the Ministry of Health in Mexico for patients with type-2 diabetes using a quasi-experimental, retrospective design.

Recommended citation: Sosa-Rubí, S., Contreras-Loya, D., Pedraza-Arizmendi, D., Chivardi-Moreno, C., Alarid-Escudero, F., López-Ridaura, R., Serván-Mori, E., Molina-Cuevas, V., Casales, G., Espinos-López, C., GonzálezRoldán, J. F., Silva-Tinoco, R., Seiglie, J., & Gómez-Dantés, O. (2020). Cost-effectiveness analysis of a multidisciplinary health-care model for patients with type-2 diabetes implemented in the public sector in Mexico: A quasi-experimental, retrospective evaluation. Diabetes Research and Clinical Practice, 2020;167(108336):1-8. https://doi.org/10.1016/j.diabres.2020.108336. https://doi.org/10.1016/j.diabres.2020.108336

Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers

Published in Medical Decision Making Policy & Practice, 2020

In this paper, a Markov decision model is used to estimate outcomes of strategies for cervical cancer screening recommended for women at age 30.

Recommended citation: Holt HK, Kulasingam S, Sanstead EC, Alarid-Escudero F, Smith-McCune K, Gregorich SE, Silverberg M, Huchko MJ, Kuppermann M, Sawaya G Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers. Medical Decision Making Policy & Practice, 2020;5(2):1-7. https://doi.org/10.1177/2381468320952409. https://doi.org/10.1177/2381468320952409

Estimating the Natural History of Cervical Carcinogenesis Using Simulation Models: A CISNET Comparative Analysis

Published in JNCI Journal of the National Cancer Institute, 2020

This paper is about the comparative modeling analysis to characterize the age of acquisition of cancer-causing HPV infections and implied dwell times for distinct phases of cervical carcinogenesis with three different CISNET cervix models.

Recommended citation: Burger EQ, de Kok IMCM, Groene E, Killen J, Canfell C, Kulasingam S, Kuntz KM, Matthijsse S, Regan C, Simms K, Sy S, Alarid-Escudero F, Vaidyanathan V, van Ballegooijen M, Kim JJ. (2020). "Estimating the Natural History of Cervical Carcinogenesis Using Simulation Models: A CISNET Comparative Analysis." JNCI Journal of the National Cancer Institute. 2020;112(9):955–963. https://doi.org/10.1093/jnci/djz227

Estimating Population-Based Recurrence Rates of Colorectal Cancer over Time in the United States

Published in Cancer Epidemiol Biomarkers Prevention, 2020

In this paper, we used a statistical continuous-time multistate survival model to derive population-based annual colorectal cancer recurrence rates from 6 months to 10 years after colorectal cancer diagnosis using relative survival data from the Surveillance, Epidemiology, and End Results Program.

Recommended citation: Kunst, N., Alarid Escudero, F., Aas, E., Coupé, V. M. H., Schrag, D., & Kuntz, K. M. (2020). Estimating population-based recurrence rates of colorectal cancer over time in the United States. Cancer Epidemiology Biomarkers and Prevention, 29(12), 2710-2718. https://doi.org/10.1158/1055-9965.EPI-20-0490 https://doi.org/10.1158/1055-9965.EPI-20-0490

How do Covid-19 policy options depend on end-of-year holiday contacts in Mexico City Metropolitan Area? A Modeling Study

Published in medRxiv , 2020

In this paper, we use SC-COSMO, a dynamic compartmental Covid-19 model, to evaluate scenarios considering combinations of increased contacts during the holiday season, intensification of social distancing, and school reopening in Mexico City Metropolitan Area.

Recommended citation: Alarid-Escudero F, Gracia V, Luviano A, Peralta Y, Reitsma MB, Claypool AL, Salomon JA, Studdert DM, Andrews, JR, Goldhaber-Fiebert JD, SC-COSMO Modeling Consortium. How do Covid-19 policy options depend on end-of-year holiday contacts in Mexico City Metropolitan Area? A Modeling Study. medRxiv 2020.12.21.20248597. 2020. https://doi.org/10.1101/2020.12.21.20248597

Cost-effectiveness of prevention and early detection of gastric cancer in Western countries

Published in Best Practice & Research Clinical Gastroenterology, 2021

In this paper, we provide an overview of modelling studies evaluating the cost-effectiveness of gastric cancer screening and surveillance in Western countries.

Recommended citation: Iris Lansdorp-Vogelaar, Reinier G.S. Meester, Monika Laszkowska, Fernando Alarid Escudero, Zachary J. Ward, Jennifer M. Yeh, Cost-effectiveness of prevention and early detection of gastric cancer in Western countries, Best Practice & Research Clinical Gastroenterology, Volumes 50–51, 2021, 101735, ISSN 1521-6918, https://doi.org/10.1016/j.bpg.2021.101735. https://doi.org/10.1016/j.bpg.2021.101735

Towards a Public Health Approach to Homicides in Mexico

Published in SSRN, 2021

In this paper, we analyzed publicly available data in Mexico from 1998 to 2019 to calculate homicide rates and compare them to other causes of death stratified by age and sex. This study reveals important patterns of homicide deaths that can inform national and regional public health policy.

Recommended citation: Luviano A, Jalal H, Miranda A, Madrazo A, Reich M, Alarid-Escudero F. Towards a Public Health Approach to Homicides in Mexico. 2020. Available at SSRN: https://ssrn.com/abstract=3795313 https://dx.doi.org/10.2139/ssrn.3795313

BayCANN: Streamlining Bayesian Calibration With Artificial Neural Network Metamodeling

Published in Frontiers in Physiology, 2021

In this paper, we propose to use artificial neural networks (ANN) as one practical solution to the many challenges of using Bayesian calibration in health decision sciences.

Recommended citation: Jalal H, Trikalinos TA and Alarid-Escudero F (2021) BayCANN: Streamlining Bayesian Calibration With Artificial Neural Network Metamodeling. Front. Physiol. 12:662314. https://doi.org/10.3389/fphys.2021.662314 https://doi.org/10.3389/fphys.2021.662314

COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors

Published in Journal of General Internal Medicine, 2021

In this paper, we aim to quantify changes to California’s prison population since the pandemic began and identify risk factors for COVID-19 infection. We used Cox proportional hazard models to estimate the association between rates of COVID-19 infection and room occupancy and out-of-room labor, respectively.

Recommended citation: Chin, E.T., Ryckman, T., Prince, L. et al. COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors. J GEN INTERN MED 36, 3096–3102 (2021). https://doi.org/10.1007/s11606-021-07022-x. https://doi.org/10.1007/s11606-021-07022-x

The Household Secondary Attack Rate of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Rapid Review

Published in Clinical Infectious Diseases, 2021

In this paper, we gathered and analyzed data from 22 published and prepublished studies from 10 countries (20 291 household contacts). The aim of the study is to undestand the nature and determinants of household transmission.

Recommended citation: Hannah F Fung, Leonardo Martinez, Fernando Alarid-Escudero, Joshua A Salomon, David M Studdert, Jason R Andrews, Jeremy D Goldhaber-Fiebert, Stanford-CIDE Coronavirus Simulation Model (SC-COSMO) Modeling Group, The Household Secondary Attack Rate of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Rapid Review, Clinical Infectious Diseases, Volume 73, Issue Supplement_2, 1 August 2021, Pages S138–S145, https://doi.org/10.1093/cid/ciaa1558. https://doi.org/10.1093/cid/ciaa1558

Comparing the Cost-Effectiveness of Innovative Colorectal Cancer Screening Tests

Published in Journal of the National Cancer Institute, 2021

In this study, the Microsimulation Screening Analysis-Colon (MISCAN-Colon) model was used to evaluate the comparative cost-effectiveness of the PillCam, the CTC, the mtSDNA, and the mSEPT9 as alternatives to the fecal immunochemical test (FIT) and colonoscopy screening.

Recommended citation: Iris Lansdorp-Vogelaar, Reinier G.S. Meester, Monika Laszkowska, Fernando Elisabeth F P Peterse, PhD, Reinier G S Meester, PhD, Lucie de Jonge, MSc, Amir-Houshang Omidvari, MD, Fernando Alarid-Escudero, PhD, Amy B Knudsen, PhD, Ann G Zauber, PhD, Iris Lansdorp-Vogelaar, PhD, Comparing the Cost-Effectiveness of Innovative Colorectal Cancer Screening Tests, JNCI: Journal of the National Cancer Institute, Volume 113, Issue 2, February 2021, Pages 154–161, https://doi.org/10.1093/jnci/djaa103 https://doi.org/10.1093/jnci/djaa103

Outbreaks of COVID-19 variants in US prisons: a mathematical modelling analysis of vaccination and reopening policies

Published in The Lancet Public Health, 2021

In this study, we used simulation modelling to assess how the size and consequences of COVID-19 outbreaks stemming from the introduction of a viral variant into a US prison depend on baseline immunity, vaccine coverage, and whether and how activities are resumed.

Recommended citation: Theresa Ryckman, Elizabeth T Chin, Lea Prince, David Leidner, Elizabeth Long, David M Studdert, Joshua A Salomon, Fernando Alarid-Escudero, Jason R Andrews, Jeremy D Goldhaber-Fiebert, Outbreaks of COVID-19 variants in US prisons: a mathematical modelling analysis of vaccination and reopening policies, The Lancet Public Health, Volume 6, Issue 10, 2021, Pages e760-e770, ISSN 2468-2667, https://doi.org/10.1016/S2468-2667(21)00162-6. https://doi.org/10.1016/S2468-2667(21)00162-6

Dependence of COVID-19 Policies on End-of-Year Holiday Contacts in Mexico City Metropolitan Area: A Modeling Study

Published in MDM Policy & Practice, 2021

We used the Stanford-CIDE Coronavirus Simulation Model (SC-COSMO) to show that there is a high probability that the hospital capacity of the Mexico City Metropolitan Area will be outstripped by early January 2021. The SC-COSMO is a dynamic transmission model that accounts for realistic contact patterns based on adjusted population density and community and household transmission.

Recommended citation: Alarid-Escudero, F., Gracia, V., Luviano, A., Roa, J., Peralta, Y., Reitsma, M. B., Claypool, A. L., Salomon, J. A., Studdert, D. M., Andrews, J. R., & Goldhaber-Fiebert, J. D. (2021). Dependence of COVID-19 Policies on End-of-Year Holiday Contacts in Mexico City Metropolitan Area: A Modeling Study. MDM Policy & Practice. https://doi.org/10.1177/23814683211049249. https://doi.org/10.1177/23814683211049249

Age-specific rates of onset of cannabis use in Mexico

Published in Addictive Behaviors, 2021

In this study, we estimate the age-specific rates of onset of cannabis use in Mexico between 1998 and 2016. We found that across recent cohorts, the rates of onset have increased for both males and females, but at a faster rate among females.

Recommended citation: Mauricio López-Méndez, Angélica Ospina-Escobar, Rowan Iskandar, Fernando Alarid-Escudero, Age-specific rates of onset of cannabis use in Mexico, Addictive Behaviors, Volume 122, 2021, 107038, ISSN 0306-4603, https://doi.org/10.1016/j.addbeh.2021.107038. https://doi.org/10.1016/j.addbeh.2021.107038

Retention in Care, Mortality, Loss-to-Follow-Up, and Viral Suppression among Antiretroviral Treatment-Naïve and Experienced Persons Participating in a Nationally Representative HIV Pre-Treatment Drug Resistance Survey in Mexico.

Published in Pathogens, 2021

In this paper, we describe associations of pretreatment drug resistance (PDR) with clinical outcomes such as remaining in care, loss to follow-up (LTFU), viral suppression, and death in Mexico. The study was conducted in real-life clinical settings.

Recommended citation: Caro-Vega Y, Alarid-Escudero F, Enns EA, Sosa-Rubí S, Chivardi C, Piñeirúa-Menendez A, García-Morales C, Reyes-Terán G, Sierra-Madero JG, Ávila-Ríos S. Retention in Care, Mortality, Loss-to-Follow-Up, and Viral Suppression among Antiretroviral Treatment-Naïve and Experienced Persons Participating in a Nationally Representative HIV Pre-Treatment Drug Resistance Survey in Mexico. Pathogens. 2021; 10(12):1569. https://doi.org/10.3390/pathogens10121569

Prioritizing Research Informing Antibiotic Prophylaxis Guidelines for Knee Arthroplasty Patients

Published in JDR Clinical & Translational Research, 2022

The results of this value-of-information analysis demonstrate that there is substantial uncertainty around clinical, health status, and economic parameters that may influence the antibiotic prophylaxis guidance for dental patients with total knee arthroplasty (TKA). The analysis supports the contention that conducting additional clinical research to reduce decision uncertainty is worth pursuing and will inform the antibiotic prophylaxis debate for clinicians and dental patients with prosthetic joints.

Recommended citation: Kuntz KM, Alarid-Escudero F, Swiontkowski MF, and Skaar DD. “Prioritizing Research Informing Antibiotic Prophylaxis Guidelines for Knee Arthroplasty Patients.” JDR Clinical & Translational Research. 2022;7(3):298-306. https://doi.org/10.1177/23800844211020272

Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Among Incarcerated People in California State Prisons: Retrospective Cohort Study

Published in Clinical Infectious Diseases, 2022

The California Department of Corrections and Rehabilitation (CDCR), which operates the second-largest state prison system, launched a COVID-19 vaccination program on 22 December 2020, and rapidly scaled up the program across its 35 prisons [14]. CDCR has collected detailed data relevant to COVID-19 risks, interventions, and outcomes, and has maintained an extensive, multilayered testing program since early in the pandemic when large outbreaks occurred [15, 16]. We analyzed these data to estimate effectiveness of mRNA vaccines against confirmed SARS-CoV-2 infection among nearly 61,000 incarcerated people in California.

Recommended citation: Chin ET, Leidner D, Zhang Y, Long E, Prince L, Schrag SJ, Verani JR, Wiegand RE, Alarid-Escudero F, Goldhaber-Fiebert JD, Studdert DM, Andrews JR, Salomon JA,. Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Among Incarcerated People in California State Prisons: Retro- spective Cohort Study Clinical Infectious Diseases, 2022;75(1):e838-e845. https://academic.oup.com/cid/article/75/1/e838/6515675

CDX2 Biomarker Testing and Adjuvant Therapy for Stage II Colon Cancer: An Exploratory Cost-Effectiveness Analysis

Published in Value in Health, 2022

In this paper, we developed a decision model to evaluate the cost-effectiveness of testing for the absence of CDX2 expression followed by adjuvant chemotherapy (FOLFOX) for patients with stage II colon cancer.

Recommended citation: Fernando Alarid-Escudero, Deborah Schrag, Karen M. Kuntz, CDX2 Biomarker Testing and Adjuvant Therapy for Stage II Colon Cancer: An Exploratory Cost-Effectiveness Analysis, Value in Health, 2022;25(3):409-418. https://doi.org/10.1016/j.jval.2021.07.019

Characterization and Valuation of the Uncertainty of Calibrated Parameters in Microsimulation Decision Models

Published in Frontiers in Physiology (Computational Physiology and Medicine), 2022

In this article, we showed that Extreme-scale Model Exploration with Swift (EMEWS) could facilitate the use of HPC to implement computationally demanding Bayesian calibration routines to correctly characterize the uncertainty of the calibrated parameters of microsimulation DMs and propagate it in the evaluation of CEA of screening strategies and quantify their value of information. This study’s methodology and results could guide a similar VOI analysis on CEAs using microsimulation DMs to determine where more research is needed and guide research prioritization.

Recommended citation: Alarid-Escudero F, Knudsen AB, Ozik J, Collier N, Kuntz KM. Characterization and valuation of the uncertainty of calibrated parameters in microsimulation decision models. Frontiers in Physiology (Computational Physiology and Medicine), 2022;13(780917):1-12. https://www.frontiersin.org/articles/10.3389/fphys.2022.780917/full

Methods for communicating the impact of parameter uncertainty in a multiple strategies cost-effectiveness comparison

Published in Medical Decision Making, 2022

This article contains an overview of methods for presenting uncertainty in multiple-strategy cost-effectiveness analyses. Code in Microsoft Excel and R is provided to easily analyze data using the methods discussed in this article.

Recommended citation: Wolff HB, Qendri V, Kunst N, Alarid-Escudero F, Coupé VMH. Methods for communicating the impact of parameter uncertainty in a multiple strategies cost-effectiveness comparison. Medical Decision Making. 2022;42(7):956-968. https://journals.sagepub.com/doi/full/10.1177/0272989X221100112

An Introductory Tutorial on Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example

Published in Medical Decision Making, 2022

In this tutorial, we construct time-independent cohort state-transition models (cSTMs) using a previously published decision model, calculate costs and effectiveness outcomes, conduct a cost-effectiveness analysis of multiple strategies, and conduct a probabilistic sensitivity analysis.

Recommended citation: Alarid-Escudero F, Krijkamp EM, Enns EA, Yang A, Hunink MGM, Pechlivanoglou P, Jalal H. An Introductory Tutorial on Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example. Medical Decision Making. 2022;(Online First). https://journals.sagepub.com/doi/10.1177/0272989X221103163

Dynamics of Respiratory Infectious Diseases in Incarcerated and Free-Living Populations: A Simulation Modeling Study

Published in Medical Decision Making, 2022

We find a magnification-reflection dynamic: a small outbreak in a community can cause a larger outbreak in a correctional facility, which can then cause a second, larger outbreak in the community.For public health decision makers considering contexts most susceptible to this dynamic, we find that the dynamic is strongest when the community size is relatively small, initial community R-effective is near 1, and the initial prevalence of immunity in the correctional population is low; the timing of the correctional magnification and community reflection peaks in infection prevalence are primarily governed by the initial R-effective for each setting.

Recommended citation: Weyant C, Lee S, Chin E, Alarid-Escudero F, Goldhaber-Fiebert JD. The Dynamics of Respira- tory Infectious Diseases in Incarcerated and Free-Living Populations: A Simulation Modeling Study. Medical Decision Making, 2022 (Online first). https://journals.sagepub.com/doi/10.1177/0272989X221115364

A Tutorial on Time-Dependent Cohort State-Transition Models in R using a Cost-Effectiveness Analysis Example

Published in Medical Decision Making, 2022

This tutorial shows how to implement time-dependent cohort state-transition models (cSTMs) to conduct cost-effectiveness analyses (CEA) in R, where transition probabilities and rewards vary by time.

Recommended citation: Alarid-Escudero F, Krijkamp EM, Enns EA, Yang A, Hunink MGM, Pechlivanoglou P, Jalal H. A Tutorial on Time-Dependent Cohort State-Transition Models in R using a Cost-Effectiveness Analysis Example. Medical Decision Making. 2022;(Online First). https://doi.org/10.1177/0272989X221121747

software

Age mixing

Published:

Recommended citation: Caleb Easterly, & Fernando Alarid-Escudero. (2018). caleb-easterly/mixage: Published version (v1.0). Zenodo. https://doi.org/10.5281/zenodo.1322780.

dshr

Published:

Recommended citation: Alarid-Escudero F, (2019). {dshr}: an R package that implements the methods to derive disease-specific hazard ratios (dsHR) from overall hazard ratios (oHR) (Version v0.1.1). Zenodo. 10.5281/zenodo.3546663.

darthpack

Published:

Recommended citation: Alarid-Escudero F, Pechlivanoglou P, Jalal H, Kao S, Yang A, Enns E, (2019). Decision Analysis in R for Technologies in Health (DARTH) (Version v0.1.1). Zenodo. 10.5281/zenodo.3445451.

dampack: Decision-Analytic Modeling Package

Published:

Recommended citation: Alarid-Escudero F, Knowlton G, Easterly C, Enns E (2021). “Decision Analytic Modeling Package (dampack).” R package version 1.0.0, https://github.com/DARTH-git/dampack.

cdx2cea

Published:

Recommended citation: Alarid-Escudero F, Schrag D, Kuntz KM (2021). {cdx2cea}: A cost-efectiveness analysis of testing stage II colon cancer patients for the absence of CDX2 biomarker followed by adjuvant chemotherapy (Version v1.0.0). Zenodo. 10.5281/zenodo.5093594.

Stanford-CIDE Coronavirus Simulation Model (SC-COSMO) in Mexico City Metropolitan Area (MCMA)

Published:

Recommended citation: Alarid-Escudero F, Gracia V, Luviano A, Roa J, Peralta Y, Reitsma MB, Claypool AL, Salomon JA, Studdert DM, Andrews JR, Goldhaber-Fiebert JD, Stanford-CIDE Coronavirus Simulation Model (SC-COSMO) Modeling Consortium (2021). {sccosmomcma}: An R package that implements the Stanford-CIDE Coronavirus Simulation Model (SC-COSMO) to the covid-19 pandemic in late 2020 and early 2021 in the Mexico City Metropolitan Area (MCMA) (Version v1.0.0). Zenodo. https://zenodo.org/badge/latestdoi/371769010.

talks

Calibration of piecewise Markov models using a Bayesian change-point analysis through an iterative convex optimization algorithm

Published:

Abstract

Purpose

Relative survival, as reported by the Surveillance, Epidemiology, and End Results (SEER) Program, represents cancer survival in the absence of other causes of death. Often, cancer Markov models have a distant metastasis state, a state not directly observed in SEER, from which cancer deaths are presumed to occur. The aim of this research is to use a novel approach to calibrate the transition probabilities to and from an unobserved state of a Markov model to fit a relative survival curve.

Calibration of piecewise Markov models using a Bayesian change-point analysis through an iterative convex optimization algorithm

Published:

Abstract

Purpose

Relative survival, as reported by the Surveillance, Epidemiology, and End Results (SEER) Program, represents cancer survival in the absence of other causes of death. Often, cancer Markov models have a distant metastasis state, a state not directly observed in SEER, from which cancer deaths are presumed to occur. The aim of this research is to use a novel approach to calibrate the transition probabilities to and from an unobserved state of a Markov model to fit a relative survival curve.

Comparison of calibration methods for natural history simulation models

Published:

Abstract

Purpose

Disease natural history models often contain parameters that are unknown or unobservable for different reasons (e.g., ethical or financial). Calibration is the process of estimating these parameters by matching model outputs to observed clinical or epidemiological data. Our objective is to compare four different calibration methods on how they perform recovering the true parameters.

The DARTH initiative: Promoting the Use of Open-Source Software in Medical Decision Making

Published:

Open-source software (OSS) has gained significant popularity across many academic disciplines such as statistics and engineering. There have been many developments and exhibitions of the use of OSS in health decision sciences (HDS), but certainly not enough. Some of the most popular models used in HDS are being implemented in either domain-specific or proprietary software. There are many advantages to this approach, but there are also significant drawbacks, namely high entry costs, lack of transparency and a fragmented modeling approach. The Decision Analysis in R for Technologies in Health (DARTH) initiative is a multi-institutional, multi-university collaborative effort comprised of scholars who have a passion for transparent and open-source solutions to decision analysis in HDS. This meeting will highlight the benefits of OSS, the research advancements and educational initiatives currently available in decision analysis using OSS and will foster discussion around the many exciting ways in which OSS can be used to advance the field of HDS.

teaching

Applications in Biostatistics

Graduate course, Masters in Health Economics, The National Institute of Public Health of Mexico (INSP), 2010

This course is aimed at students of the Masters in Health Economics.

Advanced Topics in Health Economics

Graduate course, Masters in Health Economics, The National Institute of Public Health of Mexico (INSP), 2011

This course is aimed at students of the Masters in Health Economics.

Applications in Mathematical Statistics I

Graduate course, Masters in Health Economics, The National Institute of Public Health of Mexico (INSP), 2011

This course is aimed at students of the Masters in Health Economics.

Mathematical Statistics II

Graduate course, Masters in Health Economics, The National Institute of Public Health of Mexico (INSP), 2011

This course is aimed at students of the Masters in Health Economics.

Decision Modeling Using R

Short Course, Annual European Meeting of SMDM, 2016

Introduction to Decision Modelling Using R is a short course aimed at researchers that want to learn how to implement simple decision trees and Markov models using R.

International Health Systems

Guest lecturer, , 2016

Lecture: Health care decision making in Mexico: The role of HTA and economic evaluation Instructor: Lynn Blewett, PhD

Cost-effectiveness Analysis in Health Care

Guest lecturer, , 2017

Lecture: Value of Information Lecture: TreeAge Pro 1: Decision Trees and Cost-Effectiveness Analysis Lecture: TreeAge Pro 2: Sensitivity Analysis Lecture: TreeAge Pro 3: Markov Models Lecture: TreeAge Pro 4: Probabilistic Sensitivity Analysis Instructor: John A. Nyman, PhD

Decision Modeling in R: A 3-day course

Workshop, The Hospital for Sick Children Research Institute, 2017

Introduction to Decision Modelling Using R is a short course aimed at researchers that want to learn how to implement simple decision trees and Markov models using R.

Decision Modeling in R

Workshop, Merck, 2018

Introduction to Decision Modelling Using R is a short course aimed at researchers that want to learn how to implement simple decision trees and Markov models using R.

Decision Modeling in R

Workshop, University of Oslo, 2018

Introduction to Decision Modelling Using R is a short course aimed at researchers that want to learn how to implement simple decision trees and Markov models using R.

Decision Modeling in R: A 3-day course

Workshop, The Hospital for Sick Children Research Institute, 2018

Introduction to Decision Modelling Using R is a short course aimed at researchers that want to learn how to implement simple decision trees and Markov models using R.

Decision Modeling in R: A 2-day course

Workshop, Leiden University Medical Center, 2018

Introduction to Decision Modelling Using R is a short course aimed at researchers that want to learn how to implement simple decision trees and Markov models using R.

The Use of Decision Analysis in Drug Policy

Guest Lecture, Diploma in Drug Policy, Health and Human Rights 2019, Center for Research and teaching in Economics, 2019

This course is aimed at students of Diploma in Drug Policy.

Statistics

Graduate course, Master in Methods for Public Policy Analysis (METPOL), Center for Research and Teaching in Economics (CIDE) Región Centro, 2019

This course is aimed at students of the Master in Methods for Public Policy Analysis (METPOL) who need rigorous knowledge of probability and statistics with public policy applications.

Optimal Research Design Using Value of Information

Short course, 41st Annual North American Meeting of Society for Medical Decision Making (SMDM), 2019

This course is aimed at researchers that want to learn about the Expected Value of Sample Information (EVSI), and how it can be used to design research studies.

Quantitative Methods 1

Undergraduate course, Bachelors in Public Policy, Center for Research and Teaching in Economics (CIDE) Región Centro, 2020

This course is aimed at students of the Bachelors in Public Policy (LPP) who need rigorous knowledge of the theory and and applications of the linear regression model por policy analysis.

Decision Modeling in R: A 5-day course

Workshop, The Hospital for Sick Children, Toronto, Canada, 2020

Introduction to Decision Modelling Using R is a short course aimed at researchers that want to learn how to implement simple decision trees and Markov models using R.

Decision Sciences Methods

Graduate course, Master in Methods for Public Policy Analysis (METPOL), Center for Research and Teaching in Economics (CIDE) Región Centro, 2020

This course is aimed at students of the Master in Methods for Public Policy Analysis (METPOL) who need rigorous knowledge of probability and statistics with public policy applications.

teachingmaterial

Estimation of Transition Matrices

Published:

Transition probability matrix

A Markov model with $M$ states will have the transition matrix \(P= \begin{bmatrix} p_{1,1} & p_{1,2} & \cdots & p_{1,M} \\ p_{2,1} & p_{2,2} & \cdots & p_{2,M} \\ \vdots & \vdots & \ddots & \vdots \\ p_{M,1} & p_{M,2} & \cdots & p_{M,M} \end{bmatrix},\) where $p_{i,j}$ is the trasnistion probability from state $i$ to state $j$ in period $T$.